Placenta Praevia
🚨 Symptoms
Painless, bright red vaginal bleeding in second half of pregnancy (after 20 weeks); bleeding may be triggered by intercourse or vaginal examination; sometimes asymptomatic (found on routine ultrasound)
🔍 Causes
Placenta implants low in uterus, covering part or all of the cervix (internal os); risk factors: previous placenta praevia, previous caesarean birth, multiple pregnancies, advanced maternal age (>35), smoking, IVF pregnancy, uterine abnormalities
💊 Treatment
Pelvic rest (no intercourse, no vaginal examinations), hospitalization for bleeding episodes, corticosteroids for fetal lung maturity if preterm delivery likely, planned caesarean delivery (usually at 36-37 weeks), blood transfusion if significant hemorrhage
📝 Nursing Care
Monitor bleeding (amount, color), assess for signs of shock (tachycardia, hypotension), monitor fetal heart rate, prepare for emergency caesarean if heavy bleeding, educate on activity restrictions, NO vaginal examinations (can cause hemorrhage)
Source: NHS Scotland. For educational purposes only.